Which Infants and Toddlers Merit Extended Nirsevimab Prophylaxis in a Second RSV Season?

Which infants should receive nirsevimab in their first RSV season?

Give nirsevimab to infants aged <8 months who are born during or entering their first RSV season if they are not protected by maternal RSV vaccination. In practice, that means eligible first-season infants whose pregnant parent did not receive RSV vaccine, whose vaccination status is unknown, or who were born ≤14 days

What is the correct nirsevimab dose and how is it administered in a child over 8 months?

Do not give nirsevimab to a child over 8 months old for their first RSV season. For first-season prophylaxis, nirsevimab is for infants <8 months old; the dose is 50 mg IM once if <5 kg or 100 mg IM once if ≥5 kg. - If the child is 8 months old and this is truly their first RSV season: nirsevimab is generally not indic

How do I identify toddlers with residual severe-RSV risk who warrant continued prophylaxis after infancy?

Continue nirsevimab only for toddlers entering their second RSV season who still meet a recognised high-risk category; do not continue it routinely after a standard first season. In practice, identify residual risk by checking for ongoing CLD of prematurity needing recent medical support, severe immunocompromise, sever

If a high-risk child presents after RSV circulation has begun, is nirsevimab still worth giving?

Give nirsevimab even if the RSV season has already started, as long as the infant is still age-eligible and has not already received that season’s dose. For a high-risk infant presenting late, there is still benefit because protection is intended for the remainder of the season, not only before season onset. - Administ

What safety considerations apply when giving nirsevimab to an immunocompromised child?

Give nirsevimab if indicated; immunocompromise is not itself a contraindication, but check carefully for prior serious hypersensitivity, bleeding risk from IM injection, and whether the child has already received palivizumab or another RSV-prevention product this season. Observe after administration and document/report